American Journal of Perinatology

OBJECTIVE: To estimate national time-trends of overall and state-wise antibiotic utilization (AU) rates for suspected neonatal sepsis (SNS) in the United States. STUDY DESIGN: In this cross-sectional study, we used retrospective linked-birth-cohort and vital records data from CDC-WONDER database for the years 2016- 2020 and analyzed data containing antibiotic use for SNS. The primary outcome was proportional national and state-specific AU rates per 1000 live births during the birth hospitalization...

OBJECTIVE: To assess interaction effects between gestational age and birth weight on 30-day unplanned hospital readmission following discharge from the neonatal intensive care unit (NICU). To assess the relationship between gestational age and day of life (DOL) on neonatal intensive care unit (NICU) admission and the risk for 30-day unplanned hospital readmission (UHR). METHODS: Retrospective study using the study site's Children's Hospitals Neonatal Database (CHND) and electronic health records were used...

OBJECTIVE:  We sought to evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on perinatal outcomes while accounting for maternal depression or perceived stress and to describe COVID-specific stressors, including changes in prenatal care, across specific time periods of the pandemic. STUDY DESIGN:  Data of dyads from 41 cohorts from the National Institutes of Health Environmental influences on Child Health Outcomes Program ( N  = 2,983) were used to compare birth outcomes before and during the pandemic ( n  = 2,355), and a partially overlapping sample ( n  = 1,490) responded to a COVID-19 questionnaire...

Objective A ventricle-to-brain index (VBI) >0.35 is associated with low scores on the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III), in preterm infants with birthweight <1250 g. However, VBI obtained at the 3rd ventricle has only moderate interobserver reliability. The objective of this study was to test (1) reliability of VBI measured at the foramen of Monro on the latest ultrasonogram before discharge using the intraclass correlation coefficient (ICC) and (2) the relationship between VBI and BSID-III scores at ≥18 months corrected age...

OBJECTIVE: The aim of this study was to assess the Neonatal Resuscitation and Adaptation Score (NRAS) value compared to the conventional and combined Apgar scores in predicting neonatal morbidity and mortality. DESIGN: A prospective cohort study was conducted on 289 neonates delivered at Menoufia University Hospitals. Trained physicians measured conventional Apgar score, combined Apgar score, and NRAS for the neonates at 1 and 5 minutes after delivery in the delivery room...

Objective Gestational diabetes mellitus (GDM) requires close surveillance of blood glucose to prevent perinatal morbidity. Self-monitoring of capillary blood glucose (BGM) comes with considerable psychosocial burden. Intermittently scanned CGM (isCGM) devices are discreet and could considerably impact the lifestyle of the patient. They are designed to replace BGM testing in nonpregnant patients. Data on this technology in pregnancy is scant. The aim of this study was to assess concordance of BGM with isCGM in GDM...

OBJECTIVE: Hearing loss is increasingly prevalent among younger adults, impacting health and health care use. Deaf and hard of hearing (DHH) women have a higher risk of chronic diseases, pregnancy complications and adverse birth outcomes compared to hearing women. Health care utilization patterns during the perinatal period, remains not well understood. The objective was to examine differences in antenatal emergency department and inpatient utilization among DHH and non-DHH women. STUDY DESIGN: We conducted a retrospective cohort study design to analyze 2002-2013 Massachusetts Pregnancy to Early Life Longitudinal data to compare antenatal inpatient and emergency department use between DHH (N=925) and hearing (N=2895) women with singleton deliveries...

OBJECTIVE: We aimed at assessing the association between MSAF and adverse maternal and neonatal outcomes in early-term versus late-term pregnancies. METHODS: Early term pregnancies (37-39 weeks of gestation) presented with MSAF were compared to late-term (40-42 weeks of gestation) pregnancies with MSAF. The groups were compared with respect to background characteristics, maternal outcomes and neonatal outcomes. The composite neonatal outcome was the primary outcome of the study, and secondary outcomes included the maternal and neonatal outcomes...

BACKGROUND: Infants of diabetic mothers are at higher risk of perinatal morbidities and glycemic instability, but the impact of maternal diabetes on neonatal and neurological short-term outcomes of neonates with hypoxic-ischemic encephalopathy (HIE) remains poorly described. OBJECTIVES: To determine the impact of maternal diabetes on neonatal and neurological short-term outcomes following neonatal HIE. METHODS: A retrospective single-center study including 102 term neonates with HIE who received therapeutic hypothermia (TH) treatment between 2013 and 2020...

UNLABELLED: Platelet function parameters can be predictive of several adult diseases and their severity. However, few studies report on the association between platelet indices and neonatal diseases, specifically necrotizing enterocolitis (NEC). OBJECTIVE: To investigate whether platelet indices are associated with NEC diagnosis and NEC-related mortality. METHODS: We retrospectively examined records from infants admitted to the neonatal intensive care unit with a diagnosis of NEC, verified by the presence of pneumatosis on x-ray or pathology at surgery...

OBJECTIVE: Although guidelines exist regarding optimal IPI after live birth, both optimal IPI and counseling regarding recommended IPI (rIPI) after stillbirth or neonatal death is not well established. Our goal was to describe the counseling bereaved parents receive regarding IPI, parents' reactions to that counseling, and actual IPI after loss. STUDY DESIGN: Bereaved parents who had a previous pregnancy result in stillbirth or neonatal death participated in a web-based survey...

INTRODUCTION: Physicians and other medical providers counsel patients to provide them with most important information and available medical service options. How to provide the most effective antenatal counseling is an important focus among experts. Our study focuses on the influence of the partner's involvement during antenatal genetic group counseling (AGGC). AIM: To compare the ratio of pregnant individuals who have knowledge score improvement after AGGC, with a focus on pregnant individuals who attend counseling with/without their partner and to identify other possible factors that could influence the knowledge improvement...

BACKGROUND: Newborn hypothermia has been implicated in neonatal morbidity without randomized evidence that it compromises the infant. Our objective was to determine if a difference in operating room temperature at cesarean birth impacts neonatal morbidity. METHODS: Women undergoing cesarean delivery of a liveborn infant without major malformations were included. The institutional preexisting operating room temperature of 20°C (67°F) was compared with an experimental group of 24°C (75°F) by cluster randomization assigned on a weekly basis...

The natural extension of inpatient-focused neonatal neurocritical care (NNCC) programs is the evaluation of long-term neurodevelopmental outcomes in the same patient population. A dedicated and collaborative team of neonatologists, neonatal neurologists, neuropsychologists, neurosurgeons, physical medicine and rehabilitation physicians, and psychologists are necessary to provide personalized medicine, developmental assessments, and parental education for NNCC graduates. To achieve this goal, we devised a two-clinic follow-up model at Children's Wisconsin: HOPE clinic (Healthy Outcomes Post-ICU Engagement) and DREAM clinic (Developmentally Ready: Engagement for Achievement of Milestones)...

OBJECTIVE:  The purpose of our study was to evaluate the body mass index (BMI)-specific association between early gestational weight gain (GWG) in dichorionic twin pregnancies and the risk of preeclampsia. STUDY DESIGN:  We conducted a retrospective cohort study of all dichorionic twin pregnancies from 1998 to 2013. Data were obtained from a perinatal database and chart abstraction. Prepregnancy BMI was categorized as normal (18.5-24.9 kg/m2 ), overweight (25-29...

OBJECTIVE:  Despite many benefits of tandem breastfeeding, mothers stop breastfeeding their older babies early during pregnancy due to inadequate knowledge and support. This study was conducted to determine the tandem breastfeeding experiences of mothers. STUDY DESIGN:  A phenomenological design was used in this study. The data of the study were collected between January and August 2018. In-depth, individual, open-ended interviews were carried out for data collection...

OBJECTIVE:  Children born preterm, especially those born very preterm (<32 weeks of gestational age [GA]) are at risk for poor growth and adverse neurodevelopmental outcomes. Adverse growth and neurodevelopmental outcomes in preterm children have been attributed, in part, to the aversive sounds and relative speech paucity of the neonatal intensive care unit (NICU). Experimental studies that directly expose preterm infants to speech sounds in the NICU find significant improvements in health factors relevant to neurodevelopment...

BACKGROUND: Lymphangioleiomyomatosis (LAM) is a rare, multisystem disease that primarily affects women of reproductive age. Disease progression has been linked to estrogen exposure, and as such many patients are advised to avoid pregnancy. Data are limited regarding the interaction between LAM and pregnancy, and as such we performed a systematic review to summarize available literature reporting outcomes of pregnancies complicated by maternal LAM. STUDY DESIGN: This was a systematic review including randomized controlled trials, observational studies, systematic reviews, case reports, clinical practice guidelines, and quality improvement studies with full text manuscripts or abstracts in the English language with primary data on pregnant or postpartum patients with LAM...

OBJECTIVE: It is not yet known whether systemic inflammatory indices affect the development of respiratory distress syndrome (RDS) in premature infants. We aimed to evaluate the relationship between systemic inflammatory indices obtained on the first day of life and the development of RDS in premature infants. STUDY DESIGN: Premature infants with gestational age of ≤32 weeks were included in the study. Six systemic inflammatory indices involving neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), pan-immune-inflammation value (PIV), and systemic inflammation response index (SIRI) were measured in the first 1 hours after birth and compared in premature infants with and without RDS...

OBJECTIVE: Bronchopulmonary dysplasia (BPD) is a leading cause of morbidity and mortality in neonatal intensive care units. Our aim was to evaluate association between packed red blood cell transfusion and the development of BPD in very preterm infants. STUDY DESIGN: This retrospective study of very preterm infants (mean gestational age 27.1 ± 2.4 weeks, birthweight 970 ± 271 g) was conducted at Biruni University (Turkey) between July 2016 and December 2020...